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[脑震荡急性期的脑动脉和静脉反应性]

[Arterial and venous brain reactivity in the acute period of brain concussion].

作者信息

Dicheskul M L, Kulikov V P

机构信息

Altaĭskiĭ gosudarstvennyĭ meditsinskiĭ universitet, Barnaul.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2009;109(11):65-8.

Abstract

Arterial and venous brain reactivity has been studied in 38 patients in the acute period of brain concussion (BC) and 32 healthy volunteers using transcranial color duplex scanning of brain vessels. The assessment of arterial inflow was conducted for the medial brain artery (MBA) and that of venous outflow - for the basal vein (BV) of Rosenthal. Hyperkinetic and orthostatic probes were used for assessment of cerebrovascular reactivity. BC was not accompanied by marked changes of cerebral resting hemodynamic parameters. The increase of peak blood flow velocity in MBA in the acute period which is characteristic of the brain hyperinfusion was found in 20% of patients and that in BA compensating the disturbed outflow along the surface brain system - in 25% of patients. In normalcy, the brain venous reactivity to hypercapnia was higher than arterial one and that to orthostasis corresponded to the intensity of arterial changes. The lack of quantitative differences in the reaction of arterial and venous blood flow to hypercapnia and the predominance of venous reactivity value in orthostasis in patients with BC suggest the disturbance of venous tone regulation in these patients.

摘要

采用经颅彩色双功能超声扫描脑血管的方法,对38例脑震荡(BC)急性期患者和32名健康志愿者的脑动脉和静脉反应性进行了研究。对大脑中动脉(MBA)进行动脉血流评估,对罗森塔尔基底静脉(BV)进行静脉血流评估。使用高动力和直立试验来评估脑血管反应性。BC并未伴有明显的脑静息血流动力学参数变化。在20%的患者中发现急性期MBA的峰值血流速度增加,这是脑过度灌注的特征,而在25%的患者中发现BA的峰值血流速度增加,以补偿沿脑表面系统的流出障碍。在正常情况下,脑静脉对高碳酸血症的反应性高于动脉,对直立试验的反应与动脉变化强度相对应。BC患者动脉和静脉血流对高碳酸血症反应缺乏定量差异,且在直立试验中静脉反应性值占优势,提示这些患者存在静脉张力调节障碍。

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